Contract Approval Request Form
To Be Completed by Requesting Department (#1-21)
1) Date of Request: 11/20/2025
2) Contract Type: Expense
3) Renewal Contract: No
4) Department Name: Road and Bridge
5) Department Contact: Zach Smith
6) Description: Asphalt, Oils & Emulsions
7) PEID No: 710180
8) Req No:
9) Orgkey: 2301312120
10) Object Code: 5324000 ( Road Materials)
11) Vendor: Cleveland Asphalt
12) Vendor Contract No:
Expenditure Budget/Revenue Projections
13) Fund Name: FM Lateral Road
14) Fund #: 2301
15) Current Year Budgeted: $1,280,000.00
16) Current Year Projected: $90,000
17) Year 2:
18) Year 3:
19) Year 4:
20) Year 5:
21) Totals:
To Be Completed by Purchasing Department
22) Contract Start Date: 1/24/2026
23) Auto Renewal Contract: No
24) Bid No: 25-065
25) Contract End Date: 1/23/2029
26) Contract # Issued by Purchasing Department: 238013 (SC-0000994)
NOTES: HB1295 Requested